Medication compliance is a significant issue in the care of people with mental health conditions, particularly if the mental health condition is of an enduring and severe nature. The reason for this is that there is an increased likelihood of symptoms returning without the individual maintaining adherence to a prescribed medication regime. Conditions such as schizophrenia, psychosis and bi polar disorder fall under the remit of severe and enduring mental illness and it is reported that medication non compliance is likely to have severe implications to an individual’s psychological health and wellbeing (Le Page, 2010).
Leahy (2006) estimates that up to 70% of recurrent depression ...view middle of the document...
The second part of this assignment will reflect on how the practitioner responsible for the care of Mr Smith addressed the issue of facilitating the ongoing adherence to prescribed medication by focusing on theoretical frameworks that supported and encouraged Mr Smith to review his decision and continue to accept his depot injection. Consideration will also be made to legal and ethical frameworks that should be adopted in clinical practice when addressing the issue of medication compliance.
Defining Compliance in Mental Health Care
The term compliance is defined by the Cambridge dictionary (2010) as being a process where people obey an order, rule or request and that individuals become willing to do what others want, particularly if the other person is a figure of authority. A core definition of compliance provided by Harvey (2004-09) suggests that compliance is the undertaking of activities or establishing practices or policies in accordance with the requirements or expectations of an external authority.
Compliance has been defined as the extent to which a person's behaviour coincides with medical or health advice (Haynes, 1974) and although this is an outdated definition the term compliance persists in mental health care today. In contemporary mental health care there are suggestions that the term compliance has negative connotations and it infers that an individual who does not comply is not doing as they are ‘told’ by the mental health professional (Gray, 2002). Language and communication is an important tool in mental health and it is important to place the individual with mental health problems first by using terminology that is widely acceptable to both service providers and service users (Manzi, 2008).
Repper & Perkins (1998) support this point of view and indicate that the use of words like compliance infers that patients are passive recipients of health care who should obey instructions from professionals. As modern mental health care is concerned with developing therapeutic alliances to improve outcomes (Hakan and Jan-Ake, 2010) consequently it has been proposed that the term concordance (Gray, 2002) or the phrase medication adherence (Velligan et al., 2009) should replace the use of the word compliance in an attempt to remove the unequal and passive tone the word compliance has.
For the purpose of this assignment the word compliance will be substituted by the term adherence as this implies a more collaborative approach between service providers and service users to approach the issue of medication and treatment.
Consequences of Medication Non Adherence in Schizophrenia
Schizophrenia is a complex condition and diagnosis is made on the evidence of an individual’s reported experiences (symptoms) and observable behaviours (signs) which commonly may include; delusional thinking; hallucinations, thought interference; ideas of reference, thought disorder; social withdrawal; anxiety and depression (Keen, 2003). Psychiatric treatment for...